Augmentative and Alternative Communication (AAC) is a means to express thoughts when verbal or written communication are no longer possible. While there are many low tech solutions, such as sign language, letter boards, and nonverbal expression, a communication device, also known as a Speech Generating Device (SGD) may be necessary to convey thoughts, ideas, and needs quicker and more clearly.
Steve has led the charge to help innovate and promote assistive technology.
Team Gleason recommends that people living with ALS trial multiple SGD devices, as Medicare will typically only fund one SGD every five years.
A SGD is a computer system that allows for an individual to produce novel messages, connect to the internet, and interact with their environment. Typically a SGD is made up of a computer that uses an access method and a communication software.
Access Methods
An access method is the way in which an individual interacts with the computer, for instance a mouse and keyboard in a traditional computer setup.
SGDs can utilize multiple access methods including:
- Direct Selection (Touch) – An individual touches the screen to interact with the computer.
- Switch Scanning- A software will cycle through a number of options, and when the desired option is highlighted the user presses the switch to select the highlighted option. Note that these switches can be used in combination with the two methods below.
- Head Tracking – An individual utilizes movements of the head to move the cursor and either uses a switch or other method to select.
- Eye Gaze – An individual utilizes their eye movements to move the cursor/navigate the computer and either uses a switch or other method to select.
Access methods allow for the movement of a cursor and selection of the desired key/button. These can be done through a single method or multiple methods. For instance, an individual may use a head tracking system to move a cursor and a switch at the knee to select.
It is important to note that there is no “best” access method and individuals may often use multiple methods over time. Additionally, at this time, none of the more complex methods are as fast as traditional direct selection.
Communication Software
Communication softwares are programs that allow an individual to compose messages that are then “spoken” by the speech generating device. These range from simple text boxes that resemble a word processing program to sophisticated personalized systems that include pictures, word prediction, and storing preset phrases.
For Assistance
Team Gleason typically provides assistance for persons living with ALS to obtain a SGD in two ways. If an individual is able to go through insurance for a SGD then Team Gleason can assist in covering the copay for communication devices as funds are available. If an individual is unable to go through insurance for a communication device, Team Gleason can provide a loaner device. In the case of a loaner device, we still require that the individual receive an evaluation to determine which SGD is the most appropriate fit for that pALS. We have a limited supply of devices and will attempt to provide the device recommended by the Speech-language Pathologist, but we may not be able to provide the exact device requested.
Frequently Asked Questions
Besides a Speech-Language Pathologist, who else can provide assistance with a communication device?
A: The Speech-Language Pathologist should be the initial point of contact.
Representatives from the device manufacturer will usually assist with trials, initial setup, and troubleshooting. To find a local representative, check the manufacturer’s website.
Others that may be of assistance include occupational therapists, Assistive Technology Professionals (ATP), and others within the ALS community such as the ALS Association and local support groups.
What companies sell communication devices?
A: Here are some of the companies that currently develop and sell communication devices. The companies are listed in alphabetical order, and their inclusion in this list is not a recommendation for their devices or services.
If Team Gleason offers a loaner device, how long is the loan period?
A: When Team Gleason provides a loaner device, there is no time limit associated with the device. The device can be used as long as it is needed. In a scenario where the pALS is unable to use the device, it must be returned to Team Gleason. Contact returns@teamgleason.org to arrange for the return of the device.
What is Steve’s current communication device and set up?
A: Steve is currently using a Surface Pro 6. Steve’s Surface configuration is the i5 processor, 8GB RAM, and 256GB storage. For navigating the computer, Steve is using the Tobii PcEyeMini. The PcEyeMini is an eyegaze tracker that connects to the Surface Pro via the USB port. Since the Surface Pro 6 has one USB port, Steve uses a USB hub to add more USB ports to his Surface. As a side note, Steve’s technology configuration will not work for everyone as noted in prior questions. It is specific to his physical ability and personal preferences.
I do not have a speech-language pathologist or any clinic team member available to help me understand the process of Voice Banking, Message Banking or Double Dipping; what do I do?
A: If you do not have a clinical support system working with you, we will connect you with our partners at the ALS Augmentative Communication Program at Boston Children’s Hospital, the originator of the Message Banking™ process and the Double Dipping Method, to guide you through the process.
